Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a condition that affects the hip joint. It occurs when there is abnormal contact between the femoral head (the ball-shaped top of the thigh bone) and the acetabulum (the cup-shaped socket of the pelvis). This abnormal contact can cause damage to the joint and can lead to pain, stiffness, and reduced range of motion. FAI can be caused by bony abnormalities in either the femoral head or the acetabulum, or both, and can be classified into three types: cam impingement, pincer impingement, or mixed impingement. Cam impingement occurs when there is an abnormality on the femoral head, pincer impingement occurs when there is an abnormality on the acetabulum, and mixed impingement occurs when there is an abnormality on both the femoral head and acetabulum. FAI is a common cause of hip pain in young and active individuals, particularly in athletes. Treatment options include physiotherapy, medication, and in some cases, surgery.

Causes of Femoroacetabular Impingement (FAI)

The causes of femoroacetabular impingement (FAI) are related to the bony abnormalities in the hip joint that result in abnormal contact between the femoral head and acetabulum. Here are some common causes of FAI:

Developmental Abnormalities: Some people are born with structural abnormalities in their hip joint, such as an unusually shaped femoral head or acetabulum, that can lead to FAI.

Overuse and Repetitive Motion: Athletes who engage in activities that involve repetitive hip motion, such as running, jumping, and pivoting, are at a higher risk of developing FAI. Overuse can cause damage to the hip joint and increase the risk of impingement.

Trauma: A hip injury or trauma, such as a hip dislocation or fracture, can lead to bony abnormalities that can result in FAI.

Hip Dysplasia: Hip dysplasia is a condition in which the hip joint does not develop properly, leading to abnormalities that can cause FAI.

Genetic Factors: Some people may be more prone to developing FAI due to genetic factors that affect the development of the hip joint.

It’s important to note that not all people with bony abnormalities in the hip joint will develop FAI. The condition often results from a combination of factors, including anatomical abnormalities and repetitive hip movements.

Signs and Symptoms of Femoroacetabular Impingement (FAI)

The signs and symptoms of femoroacetabular impingement (FAI) can vary depending on the type of impingement and the severity of the condition. Here are some common signs and symptoms of FAI:

Hip Pain: Pain is the most common symptom of FAI and is often felt in the groin area or deep in the hip joint. The pain may also radiate to the buttocks, thigh, or knee.

Limited Range of Motion: FAI can cause stiffness and a reduced range of motion in the hip joint, particularly with activities that involve hip flexion or rotation.

Clicking or Catching Sensation: Some people with FAI may experience a clicking or catching sensation in the hip joint when moving or rotating the hip.

Hip Instability: FAI can cause the hip joint to feel unstable or weak, particularly during activities that require sudden changes in direction.

Hip Locking: In some cases, FAI can cause the hip joint to lock or catch, making it difficult to move the hip.

Pain with Activity: Pain and discomfort may be worse during or after activities that involve repetitive hip movements, such as running, jumping, or squatting.

Limping: Severe cases of FAI can cause a limp or altered gait pattern due to pain and limited range of motion.

It’s important to see a healthcare professional if you experience any of these signs and symptoms. Early diagnosis and treatment can help prevent further damage to the hip joint and improve outcomes.

Treatment for Femoroacetabular Impingement (FAI)

Physiotherapy can be an effective treatment for femoroacetabular impingement (FAI) by helping to reduce pain, improve range of motion, and strengthen the muscles surrounding the hip joint. Here are some common physiotherapy treatments for FAI:

Stretching: Tight muscles around the hip joint can contribute to FAI symptoms. A physiotherapist can recommend stretching exercises to improve flexibility and reduce muscle tightness.

Strengthening: Strengthening exercises can help to improve the stability and control of the hip joint, reducing the risk of impingement. A physiotherapist can recommend exercises to strengthen the hip muscles, including the glutes, hip flexors, and hip rotators.

Manual Therapy: Manual therapy techniques, such as joint mobilization and soft tissue massage, can help to reduce pain, improve range of motion, and improve the alignment of the hip joint.

Activity Modification: A physiotherapist can recommend modifications to activities that exacerbate FAI symptoms, such as avoiding certain types of exercise or changing the way activities are performed to reduce stress on the hip joint.

Education: A physiotherapist can provide education on proper posture and movement patterns to reduce stress on the hip joint and prevent further damage.

Taping: Kinesiology tape can be used to support the hip joint and reduce pain during activities.

Modalities: Modalities, such as ice or heat, ultrasound, or electrical stimulation, may be used to reduce pain and inflammation in the hip joint.

It’s important to work with a qualified physiotherapist who has experience treating FAI to develop an individualized treatment plan. Treatment goals will vary depending on the severity of the condition and the individual’s goals and needs. In some cases, surgery may be necessary to correct the underlying bony abnormalities that are causing the impingement.

If you have any questions or would like to speak to a therapist about femoroacetabular impingement (FAI) please call us at 03 9836 1126.

Reference:

López-Royo MP, Reche-Navarro E, Sánchez-Rodríguez R, et al. (2021). Effectiveness of conservative physiotherapy in patients with femoroacetabular impingement syndrome: a randomized controlled trial. Physiotherapy